Smile Train is a 501(c)(3) organization based in New York City, USA. The organization was founded in 1999 and is the largest charity providing corrective surgery for children with cleft lips and palates.[1] Smile Train has established programs to provide free corrective cleft surgery in 87 countries.[2] Through these programs, the charity trains local doctors and provides funding to hospitals for the procedures.[2] According to Forbes magazine, Smile Train is the 72nd largest charity in America.[3]

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Smile Train was created in 1998 by Brian Mullaney and Charles Wang, who had previously worked with Operation Smile, another charity focused on correcting cleft lips and palates.[5] They felt the most efficient way to provide cleft surgery was to train and support local doctors rather than to fly in Western doctors to provide surgeries in poor, developing countries.[5][6] Local doctors would also be able to provide care year-round rather than the limited engagements of the "mission-based" model.[5][6]

In 1999, Smile Train began providing corrective surgeries in China.[2] The charity worked with American and Chinese presidents at the time, George H.W. Bush and Jiang Zemin, in the planning of Smile Train's first operation in China.[7] As of 2013, the charity had provided approximately 300,000 corrective surgeries in partnership with 397 local hospitals within China.[2]

Smile Train began working in India in 2000.[8] In 2011, Aishwarya Rai, a Bollywood actress and former Miss World, became Smile Train's first goodwill ambassador.[9] By 2013, Smile Train was conducting 50,000 corrective surgeries in India annually.[10]

Smile Train unveiled a new advertising campaign, "The Power of a Smile," in April 2014.[4] The campaign featured work from Kátia Lund and photojournalist Alex Webb.[4] The campaign coincided with the release of a new organizational logo.[4] That same month, Smile Train also held an event at the Barclays Center for what it said was its millionth cleft operation.[13]

In early 2011, Smile Train and Operation Smile announced the two charities would merge,[14][15] followed three weeks later by announcements the merger had been aborted,[16] Smile Train having canceled the union.[17] Smile Train's board also named Priscilla Ma the executive director of the organization, while other board members and directors stepped down.[18]

In 2009, Smile Train initiated an advertising campaign [19] in the Richmond Times highlighting Smile Train's attempts between 2006 and 2009 to donate nearly $9 million to Operation Smile,[20] the organization Brian Mullaney had split from in 1998 in what Mullaney described as a "messy divorce."[21]

In the ad, Mullaney contended Operation Smile was refusing money that could benefit children, later calling the situation "shameful";[20] Mullaney also noted that he respects that in some countries need overwhelms available doctors and he had "a newfound respect for what Operation Smile does."[21] The Virginian Pilot outlined the history and differences between the two organizations and indicated Mullaney wanted the two organizations to reconcile.[21]

At the time, Dr. Magee of Operation Smile declined a newspaper interview, and Operation Smile formally responded to the ad campaign, saying the two organizations "have different operating philosophies and business ethics," and that Operation Smile would continue foregoing donations from an "unproductive relationship."[21]

In 1999, Smile Train approached Dr. Court B. Cutting of New York University's Virtual Research Laboratory to create training videos, which could be used to train local doctors on how to perform advanced cleft surgery techniques.[22] The 3D models used in the videos were based on the CT scan of two Chinese patients.[23] Smile Train distributes the DVDs to local doctors worldwide.[6][22] The DVDs are available in English, Spanish, and Mandarin.[24]

Smile Train later used the 3D models of the two Chinese patients to build the first 3D open access virtual surgical simulator, which teaches cleft palate and lip surgery to doctors in developing countries.[25] The simulator, which was created in partnership with BioDigital Systems, is web-based, open source and available for free.[25] It does not require any special hardware to use.[26] A mobile application is under development.[26] In September 2014, Smile Train will showcase a 3D virtual surgery simulator at TEDMED 2014 in Washington DC.[27]

Smile Train maintains Smile Train Express (STX), an internet-based, digital patient record database.[7][24] STX enables Smile Train to have outside medical experts review patient records and quality of care.[6][7] The charity also boasts a large medical research library with more than 1,000 articles related to clefts accessible online for free.[28]

Smile Train helps the cause of cleft care through its funding of 1,000+ active partners representing nearly 1,200 hospitals and 2,300 partner surgeons in the world’s poorest nations; through these local partnerships, the organization is able to provide free surgery for children any day of the year, with more than 120,000 surgeries each year.[29]

In addition to partnerships with cleft care organizations, Smile Train has partnered with other individuals organizations in an effort to improve safety and quality at their partner hospitals, such as Dr. Atul Gawande, World Health Organization, World Federation of Societies of Anesthesiologists[30] and Lifebox.[31]

Smile Train has a number of corporate partnerships, including Artisanal Cheese,[32] Dubai Duty Free,[33]Estée Lauder, FedEx,[34]QBE[35] The Queens Flowers,[36] Mars Retail Group [37] and Vertu[38][39] These partnerships - in addition to those in partnership with donors on grassroots efforts - serve to both raise money and spread awareness.

SmileTrain partnered with medical visualiztation company BioDigital to create the first 3D, open access surgical simulator to teach cleft lip and palate surgeries to doctors in developing countries.[40]

In a 2008 New York Times article, economist Steven Levitt of Freakonomics fame indicated that the organization's model and its technological innovations "likely make Smile Train one of the most productive charities, dollar for deed, in the world."[55]

In 2008, Smile Train was the runner-up in the Health-Care IT category of the Wall Street Journal Technology Innovation Awards in recognition for their surgical technique training videos.[56]

In 2009, the documentary Smile Pinki, won the 2008 Oscar for Best Documentary (Short Subject).[57] The documentary was sponsored by Smile Train and directed by Megan Mylan. The film shows the story of a poor girl in rural India whose life is transformed when she receives free surgery to correct her cleft lip. Free copies of the film are available through Smile Train’s website.[58]

Smile Train complies with the 20 Standards for Charity Accountability established by the Better Business Bureau Wise Giving Alliance.[62] The alliance was developed to "assist donors in making sound giving decisions and to foster public confidence in charitable organizations."[63]

According to Smile Train's 2012 annual report, management and general expenses account for $1.9 million (1.2%) of total expenses.[64] $132.4 million (81.8%) went to program services and $27.6 million (17%) to fundraising.[64] Total support and revenue for 2012 was $175 million.[64]